For patients with aged facial features such as loose neck skin, jowls and deep nasolabial folds, facelifting still reigns supreme with respect to achieving the most substantial and lasting improvements. Facelifting is commonly combined with other facial rejuvenation procedures such as blepharoplasty (eyelid lift) and endoscopic forehead lifting, depending on the individual needs of the patient. Facelifting entails 4 components, each of which is adjusted to the needs of the patient: skin removal and tightening, underlying muscle tightening or repair (platysmaplasty, SMAS flap), fat removal from the neck and jowl areas, and sometimes fat transfer to the cheek area to restore youthfulness there.
For patients with aged facial appearance, Dr. Lindsey recommends facelifting as often the best way to start, as adjunctive procedures such as skin care, peels or laser resurfacing yield more benefit after skin tone has been improved, wrinkles eliminated, and facial contours restored (elevated cheeks, straight jawline, neck angularity). Dr. Lindsey routinely recommends underlying muscle tightening and repair, as this greatly improves the longevity of a facelift. Dr. Lindsey has published his technique of SMAS (deep plane) facelifting in Annals of Plastic Surgery.
Facelifting requires commitment on the part of the patient. Dr. Lindsey recommends 2 weeks off work for patients who have sedentary jobs. For patients with more physically-demanding jobs, more time off is required. The best results are not generally seen for at least 6-8 weeks after surgery; however, substantial visible improvements are generally visible immediately after surgery. Facelifts are not painful procedures. As with any plastic surgery procedure, attention to postoperative care is paramount to achieve the best possible result.